Implantable Nerve Stimulator Helps Alleviate OSA Symptoms

Innovative hypoglossal nerve stimulation (HGNS) implants offers promise for patients with moderate to severe obstructive sleep apnea (OSA).

Researchers at the University of Pennsylvania (Penn; Philadelphia, USA) conducted a study involving 20 patients who were implanted with the Inspire Upper Airway Stimulation device, as they were unable to tolerate continuous positive airway pressure (CPAP) treatment for OSA. All patients had information from a baseline polysomnography (PSG) recording prior to HGNS implant and again approximately two months after HGNS in order to assess the severity of their apnea and any change after treatment. Those who received the implant were typically overweight, middle aged, and had severe OSA.

The results showed that total apnea-hypopnea index (AHI)--which measures severity of sleep apnea by counting the number of pauses in breathing during sleep--for all patients significantly decreased an average of 35 events per hour after the device was planted, which corresponds to an average reduction of 84%. Additionally, the lowest oxygen level measured in the blood during the night significantly increased by 11%, from 79% to 90%. The study was presented at the 30th annual meeting of the Associated Professional Sleep Societies (SLEEP), held during June 2016 in Denver (CO, USA).

“Considering that sleep apnea can lead to high blood pressure, heart attack, stroke, and other serious health problems, it is critically important that we study devices that may serve as another option instead of CPAP to treat patients with sleep apnea,” said lead author Richard Schwab, MD, co-medical director of the Penn Sleep Center. “There is no perfect treatment option for obstructive sleep apnea, but our preliminary data suggest that hypoglossal nerve stimulation can effectively treat patients with sleep apnea who are unable to tolerate CPAP.”

The Inspire Upper Airway Stimulation device, a product of Inspire Medical Systems (Maple Grove, MN, USA), is a pacemaker with a tiny generator and a sensing lead to stimulate the tongue. Patients use a remote control to turn on the device before going to sleep and turn it off upon waking up. A delay allows the user to fall asleep before the pulse generator begins stimulation. After detecting the user's breathing pattern, the machine stimulates the hypoglossal nerve, which controls tongue motion to enlarge the upper airway.

Related Links:
University of Pennsylvania
Inspire Medical Systems